This volume, which reproduces four pamphlets from the seventeenth and eighteenth century concerning madness and its treatment, represents a wonderful addition to the history of psychiatry. In allowing us a source of comparison and contrast, accounts of madness and melancholia from past eras are particularly valuable, and the accounts in this volume are the more so because they were penned by the sufferers, or alleged sufferers.

The four different voices chosen by editor Allan Ingram, an English professor in the UK, include Mrs. Hannah Allen’s 1683 memoir of her acute melancholia together with three accounts of injustice and mistreatment as the result of perceived misdiagnosis or misunderstanding: Alexander Cruden’s 1739 ‘The London-Citizen Exceedingly Injured," Samuel Bruckshaw’s 1774 "One More Proof of the Iniquitous Abuse of Private Madhouses" and William Belcher’s brief "Address to Humanity: Containing, a Letter to Dr. Thomas Monro; a Receipt to Make a Lunatic, and Seize his Estate; and a Sketch of a True Smiling Hyena."(1796)

As the last three titles suggest, Cruden’s Bruckshaw’s and Belcher’s accounts tell us as much or more about the treatment of disorder, than about disorder itself. Nonetheless, ambiguity remains over these ostensibly wronged gentlemen. The treatment they describe receiving is abominable (Cruden’s diary reports being chained night and day, for example), and would be were they mad or – as they insist – sane. Moreover, the evidence their ruthless keepers wrongly detained them for financial gain, and of a dangerously unregulated business of private madhouses, can hardly be ignored. But whether these men were sane, or suffered delusions of persecution, remains tantalizingly unresolved.

Hannah Allen’s account of her melancholia is in this respect clearer. It is intriguing both in its detailed revelation of the symptoms which so strongly echo those of depression sufferers today, and in the way her own understanding of her disorder is shown to shift as she gradually recovers. During the worst of her suffering, she believes herself the most unredeemably evil creature on earth, a "Cursed Reprobate," not deserving to live. But writing upon her recovery she alters her view, remarking that "God convinced me by degrees; that all this was from Satan, his delusions and temptations, working in those dark and black humors…" To our secular, twenty-first century understanding, these categories are somewhat baffling. But they reflect common sixteenth and seventeenth century views which placed the causes of madness in a complex play between demonic forces and humoral states.

Hannah Allen’s treatment by others, family members and apothecaries, was notably compassionate. In contrast, Cruden’s sufferings in Wright’s private madhouse in Bethnal-Green fifty years later, or Samuel Bruckshaw’s experience of, as he reports it: "under a charge of insanity…utterly without foundation, they drag the wretched victim of their despotic violence from his business, confine him in a goal, load him with irons, and are not ashamed to call in the aid of a Keeper of a Private Mad-house, (having artfully deceived his friends, residing at a considerable distance)…prolong his confinement for near a year, to the total ruin of his fortune and of his character" are chilling.

The editor of this volume has written a brief introduction which provides background on each pamphlet’s author, comments on the social and medical practices of the times, and ends with some observations about the fierce faith in words and reason which imbue each of these texts. As he puts it: "The voices of madness rarely sound mad, and if these writers come to us from the dark…their darkness, like Malvolio’s, is that of a social rejection that is still capable of being enlightened, they trust, by a written self-renewal demonstrating their capacities for moral perspective and linguistic choice."

© 2001 Jennifer Radden

Jennifer Radden is Professor of Philosophy at the University of Massachusetts, Boston. She is the President of the Association for the Advancement of Philosophy and Psychiatry, and she is the author of two books. Recently she edited The Nature of Melancholy : From Aristotle to Kristeva.

Categories: MentalHealth, General